Addressing threats to health care's core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.

Wednesday, January 21, 2009

An Inaugural Moment to Improve Health Care

Many phrases of US President Barack Obama's inaugural address seemed to speak to issues often discussed on Health Care Renewal. See the quotes below, taken in order from the transcript of the speech, and I hope not too much out of context.

Our economy is badly weakened, a consequence of greed and irresponsibility on the part of some, but also our collective failure to make hard choices and prepare the nation for a new age.

On this day, we come to proclaim an end to the petty grievances and false promises, the recriminations and worn out dogmas, that for far too long have strangled our politics.

We remain a young nation, but in the words of Scripture, the time has come to set aside childish things.

But our time of standing pat, of protecting narrow interests and putting off unpleasant decisions — that time has surely passed.

We will restore science to its rightful place, and wield technology's wonders to raise health care's quality and lower its cost.

What the cynics fail to understand is that the ground has shifted beneath them — that the stale political arguments that have consumed us for so long no longer apply.

Those of us who manage the public's dollars will be held to account — to spend wisely, reform bad habits, and do our business in the light of day — because only then can we restore the vital trust between a people and their government.

Nor is the question before us whether the market is a force for good or ill. Its power to generate wealth and expand freedom is unmatched, but this crisis has reminded us that without a watchful eye, the market can spin out of control — and that a nation cannot prosper long when it favors only the prosperous.

To those who cling to power through corruption and deceit and the silencing of dissent, know that you are on the wrong side of history; but that we will extend a hand if you are willing to unclench your fist.

Of course, most of these remarks were not specifically about health care.

However, on Health Care Renewal we have documented multiple examples of "greed and irresponsibility" on the part of some health care leaders, and certainly our collective failure as medical professionals "to make hard choices."

Health care has seen far too many "false promises," often made to further vested interests.

The arguments too often made in support of the powers that be have been "childish."

"Narrow interests," often serving the wealth of a few privileged people, have been all too evident.

We certainly hope we can responsibly use "technology's wonders," but not naively or uncritically. We need to make health care decisions according to the best scientific evidence, critically reviewed, in conjunction with knowledge of biology, and in accord with individual patient's values and preferences, to improve health care. We need to better use information technology, but be clear-eyed about its current limitations and potential adverse effects.

We have also seen "stale political arguments" often used again to support vested interests.

Hopefully, in both the public and the private sectors of health care more leaders will "spend wisely, reform bad habits, and do ... business in the light of day."

There have not been enough "watchful eyes" on the health care "market," and hence we have repeatedly documented it has spun "out of control" in a way that often "favors only the prosperous."

We have seen people in powerful positions in health care who do so "through corruption and deceit and the silencing of dissent"

So let those of us in health care join President Obama in this aspiration:

America, in the face of our common dangers, in this winter of our hardship, let us remember these timeless words. With hope and virtue, let us brave once more the icy currents, and endure what storms may come. Let it be said by our children's children that when we were tested we refused to let this journey end, that we did not turn back nor did we falter; and with eyes fixed on the horizon and God's grace upon us, we carried forth that great gift of freedom and delivered it safely to future generations.

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FIRM - the Foundation for Integrity and Responsibility in Medicine is a 501(c)3 that researches problems with leadership and governance in health care that threaten core values, and disseminates our findings to physicians, health care researchers and policy-makers, and the public at large. FIRM advocates representative, transparent, accountable and ethical health care governance, and hopes to empower health care professionals and patients to promote better health care leadership.

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